Do you have an appointment? Yes, but you’ll still be waiting.

schmeah 15 September 2010 125

A recent experience at an Ainslie practice recently has left me pretty pissed off at the treatment of people who make appointments, keep them and yet are still expected to wait inconveniently long times for the other half to come to the party!

I had a scheduled appointment for 4 pm to see my doctor. Being retentive about making appointments and turning up on time, I rocked up at 4 and was told that said doctor had ‘1, 2, 3 oh no, 4’ patients ahead of me still waiting. I responded politely saying that I had left work early at 3:30 to make the appointment and it would have been equally polite for the surgery to call me and advise me that my doctor was so far behind schedule. I was told that ‘we don’t do that here, would you like to go away and come back in 40 minutes or stay’. Failing to see the attraction of waiting in a room full of sick people for 40 minutes, I said I’d come back.

So, turning up at 4:45 (5 minutes late I know) I was told that the doctor now had 2 people in front of me and ‘please take a seat’ – having already come from work to the doctors, gone home and returned I failed to see the benefit in going home again. So I waited, a full 30 minutes until my name finally got called .. at 5:15 pm a full hour and 15 minutes after my appointment time and nearly 2 hours after I had left work.

As I was leaving said Doctor’s office about 10 minutes later I politely stated that my appointment was at 4 pm and I didn’t get in until 5:15 pm, ‘could I please just pay the gap and be gone’. Perhaps I was stupid to think that an inner north doctor would be sympathetic to my situation because to say the least said doctor got snarky. I was told – ‘I’m not in here on holidays you know, I work hard, I’m thorough with my patients and I appreciate their patient, it’ll be $75’. Shut door.

Well said: I’d like you to note that, I too am not on holidays – in case my work clothing looks like theatre costume – I came from work to keep my appointment, leaving a full 90 minutes early. It’s very obvious that you are thorough with your patients, this is admirable, but perhaps in order to remain so diligent with their treatment and to not piss off you other patients you might like to expand your consultation times out by 10 minutes because the current system is obviously not working. Further, I am patient like everyone, I’ve waited 10 minutes here, 20 minutes there to see my doctor and I’ve never found this time lag inconvenient, it’s almost expected (sad as it is). Said doctor’s attitude was totally perplexing and offensive to say the least- I, and I imagine other patients have lives outside of the off visit to the doctor – I don’t expect to make an appointment, turn up on time and be told I will have to wait over an hour to get in – forgive me for not calling in advance but really, shouldn’t that be the surgery’s job?

When I went to pay – the full $75, I asked quietly – (even though the waiting room was empty except for one poor man who’s appointment no doubt was scheduled for 4:30) ‘is it the policy of the surgery to not contact patients when their doctor is running more than an hour behind?’. I was given the response that ‘we don’t have the facilities to do that here – we do however recommend that patients call ahead .. Just in case’

Right, so what you’re saying is that – I have to do your job for you, not only do I have to wait more than a week for an available appointment time with said doctor, I also have to call on the day to make sure everything is chugging along happily and I can expect to get in on time. Does that phone next to you work by the way? When it rings, and you answer are you just talking to yourself?

Rubbish!

I was completely outraged by this situation, that I had to wait so long beyond my appointment time to get in and then be told that in the future, it’s my job to call ahead. Unless you’re dying .. I would say go to a doctor elsewhere because the phones at this practice don’t work.

Oh goodness, is that the time? I have an appointment with my bank manager in 2 hours, I should call ahead now to make sure said manager will be available at 4 pm, like I arranged for.


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125 Responses to Do you have an appointment? Yes, but you’ll still be waiting.
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Leinna Leinna 8:36 pm 16 Sep 10

Here I was thinking you were the troll. Sorry if my last post was a touch scrambled, I was probably too stunned to believe someone thought doctors charged patients who didn’t turn up to their appointments.

My perspective is a little different as I work in the hospital.

1) I am also in Canberra and I was referring to the lack of specialists meaning that some people need to travel to Sydney for medical care. If GPs head the same way then you might need to travel to Sydney to see a GP. Sorry if it wasn’t clear.

2) The neurologist example was just one of many related to the shortage of doctors in Canberra. This will hopefully improve in the next 5 – 10 years with the ANU graduates coming in.

3) I’m glad you weren’t going to the hospital, if the GP could sort things out in 5 minutes you probably would have been waiting a long time. Although they have opened up a drop-in centre now that can issue medical certificates (I think…)

4 + 5) Again, I’m too focussed on hospital medicine. How about a patient who comes in for an asthma check, who then confides to you that they’re depressed and contemplating suicide. Or they have just developed rectal bleeding. They have developed erectile dysfunction, now there’s a short chat you can have with someone. Patients bring extra things up when they are seeing their doctor.

6) I can’t speak for the doctor in question, maybe he was just having a bad day and was grumpy? I think he should have apologised.

7) Regarding sandwiches … I wouldn’t pay you anything as I would have left after 15 minutes of waiting for a sandwich. There are lots of other sandwich shops out there. I could even make my own sandwich.

A final point – I am only posting because I think you are completely wrong about why doctors have waiting times. There are waiting times because people are sick and there aren’t enough doctors to see them. To suggest that there is some money-hungry, uncaring practice behind it is an affront to the decent and hard working GPs who are doing the best they can to help their patients. Doing their best means that delays occur.

@ The Frots, that’s pretty ordinary. In any profession there are going to be money hungry bastards I suppose 🙁 Fortunately, not the majority.
–> Are you sure it was the doctor who sent the receptionist out? I would have hoped he’d be more interested in seeing his next patient if you were on the way to the hospital.

Genie Genie 8:13 pm 16 Sep 10

Leinna said :

Wow, so many things to answer here.

Firstly, doctors charging you money if you don’t turn up to your appointment. How could you even think of this? It is:
a) not legal
b) not professional
c) not ethical
and would not be done, even by the most money-grabbing heartless doctor in Canberra. Well I hope not.
Additionalx2: I still can’t believe you think doctors would charge you money for not turning up to an appointment.

1. I think your a moron
2. Alot of doctors will charge if you don’t show up for an appointment. My physio, acupuncturist, chiro and my doctor – all charge for missed appointments. Gyms and personal trainers will charge if you do a no show. Most people who work in these professions book in their “time” not their service. If you book in an appointment from 3-330 and dont show up – that person cant just go onto the next person. They have to wait for their 330pm to arrive.

The Frots The Frots 7:42 pm 16 Sep 10

I really have to add something in here. There was talk about some doctors (and by no means all) being money hungary.

I had an experience not that long ago where, while I was being wheeled out of a northside practice on a guerney to a waiting ambulance, the receptionist was tasked (by the doctor in charge of the practice) to run alongside me while I signed the receipt for my consultation!!!

This was while I was in severe pain, a regular user of the practice in question, and ON A STRETCHER goiung to hospital. Even the receptionist herself apologised, and the ambulance crew were, well, angry on my behalf (I was rather sick at the time).

Now, this isn’t for all ACT doctors – there really are some great ones – and some nice ones. But, there really are some pricks as well……………and this one I’ll never forget!!!

Woody Mann-Caruso Woody Mann-Caruso 7:27 pm 16 Sep 10

Firstly, expand the standard consultation out to 20 minutes.

Now your doctor has 24 slots in a day to see people, so their waiting list is longer and their revenue is reduced while their fixed costs remain constant. Forget waiting 75 minutes today, because you can’t get in til next Tuesday. And people are still early or late, and take shorter or longer than 20 minutes to see, and now we’re back where we started. What part of ‘unpredictable uncertainty’ don’t you understand?

how about you employ a messaging system that tells your patients that you’re running behind

How about you get a clue and realise that doctors are always running behind? I think it might have something to do with d*ckhead whack jobs trying to argue about whether or not they should pay.

But hey, let’s humour you. How late does the doctor have to be to text people? How far into the queue should it text? Should it let you know that people have cancelled or the doctor has caught up and now you’re not late? If you get a text that says ‘Doctor Smith is currently 22 minutes behind schedule, with 4 people in the queue against a planned 3’, what exactly are you going to do with that information? Cancel or reschedule – and start the whole process all over again for everybody in the waiting list? Remember, other people are receiving similar texts, and can also act, completely without your knowledge. Surprise, surprise – texting just drags you into the same unpredictable uncertainty as the doctor, except that it gives you more options to f*ck around with the schedule and make things worse.

And your idea to discriminate against the elderly? Genius. Truly, you are the greatest thinker of our time. I love how your solution will scale with population ageing. Soon doctors may have up to 8 appointments available every day! I guess a lack of perspective isn’t your biggest problem after all.

Shall we recap? Install an alert system that will confuse people and make the schedule even more random. Reduce revenue for no benefit to anybody. Tell old people to go f*ck themselves. Is that about it for your ‘solution’?

And I’m not a medical doctor. I’m just a grown-up.

schmeah schmeah 7:27 pm 16 Sep 10

Leinna, you’re clearly a troll so I probably shouldn’t bother but;

1 – I’m not in Sydeny, I’m in canberra
2 – I don’t need to see a specialist (a neurologist) I needed to see a GP
3 – I wasn’t going to the public hospital system – see point 3 – also see a previous comment of mine where I said I would be happy to wait hours to get into the hospital because it’s free and it’s a triage system
4 – I consider an asthma attack or a severed head an emergency, if someone suffering those ailments turned up to their GP instead of calling 000, they need to have their head read as well.
5 – If a cancer patient came and saw me as a doctor, I’d encourage them to use their Medicare Safety Net privileges and book a longer appointment
6 – I didn’t get an apology – it’s nice to know I would get one from you though
7 – I hope you’re my customer experiment, please pay full price for one of my sandwiches after I make you wait 75 minutes.

All I did was turn up on time for an appointment, I don’t know why trolls like yourself have to defend behaviour that if it were to happen to you would be totally unacceptable.

Leinna Leinna 6:29 pm 16 Sep 10

Wow, so many things to answer here.

Firstly, doctors charging you money if you don’t turn up to your appointment. How could you even think of this? It is:
a) not legal
b) not professional
c) not ethical
and would not be done, even by the most money-grabbing heartless doctor in Canberra. Well I hope not.
If a patient doesn’t turn up in my practice (I’m not a GP but work as a speciality registrar) I am:
1) Worried that something particularly bad might have happened to the patient which is why they haven’t come in
2) Relieved that I will be able to catch up on my other patients if I happen to be running late
Our nursing staff contact patients to find out where they are, NOT because we want to steal their money for some nefarious purpose, but because we are genuinely concerned about that patient’s welfare.

If I’m running late, the first thing I do when I see a new patient is apologise. There are a number of reason I can run late, I’m sure a GP would have some different reasons, but they include:
1) A patient didn’t turn up on time, thereby delaying the rest of the patients (this is uncommon)
2) An emergency with another patient who is receiving treatment means that we can’t start the clinic on time. This is *common*.
3) A patient who takes longer than expected due to something like their cancer relapsing or mental health issues. No, I don’t just say “Sorry, your 15 minutes are up, see ya!”
4) Overbooked clinics. This isn’t so much of a problem in my field, but instead of your 75 minute wait how would you like to have to travel to Sydney to see a doctor. The waiting time to see a neurologist in the public system in Canberra is close to one *year*. And that’s with overbooked clinics. When a practice manager has to ‘squeeze you in’ for an urgent appointment (as with a previous poster’s ill child), that’s a double booking.

20 minute appointments? Isn’t that a large increase in the fee you have to pay? And instead of seeing 30 patients a day, you see 20 patients a day and 10 patients develop complications of whatever illness they are suffering from.

Patients with complicated medical problems, if known about, are booked for longer appointment times in most cases.

At the end of the day, if you’re someone who thinks of a doctor as nothing more than a service provider, then by all means shop around until you find someone you like. I struggle to believe that your current GP will miss your custom.

Additional: To fix the problem, you need more doctors in general practice who want to stay in Canberra. This means incentives are needed to attract doctors to become GPs in Canberra. The *only* incentive I was ever provided with was that it would probably easier to work part time and have a family, something that is proving ever more elusive in the specialist training pathways.

Additionalx2: I still can’t believe you think doctors would charge you money for not turning up to an appointment.

schmeah schmeah 5:05 pm 16 Sep 10

Here’s a solution, that no doubt – you being a doctor and so pious, will just pull apart anyway – but how about you employ a messaging system that tells your patients that you’re running behind. This would only need to be employed on the occasion where the doctor is running very late – and unless this happens a lot, shouldn’t actually cost that much. Not only will you save yourself the hassle of a ‘random’ jo slamming you on the riot act – you’ll also get a warm fuzzy feeling inside which comes with the realisation, that you’re also indirectly letting your patients know that you appreciate their time, custom and patience. Seeing as it could be automated, it wouldn’t take away from all that other important work surgery staff do – like, booking appointments that won’t be kept or liasing with labs.

Now, I don’t really think it’s my position to devise a system that works but seeing as you ask, I’ll give it a whirl.

Firstly, expand the standard consultation out to 20 minutes. While this may, as you or others have suggested, mean that the doctor has less time to see as many patients as they can, surely it would mean a better service and a reduced wait. Another rioter posted that their doctor already has a standard 20 minutes consultation time and subsequently, he/she rarely, if ever, runs late.

Secondly, perhaps those patients, known to the doctor to be either;

1) experiencing complext medical conditions or
2) repeated offenders looking for attention never keeping to a time frame

Perhaps, the doctor should have a policy where these patients are advised, and then just made to, have the longer 40 minute consultation; people who have complext conditions, are typically covered by the Medicare Safety Net after they hit a number of claims, so their treatment fee (after rebate) shouldn’t leave them penniless. Those who are just nuiscence patients – and having had a lot of experience with oldies – who, lets face it, are concerned about everything should be strongly encouraged to make a longer appointment time – or else the practice will do it for them. Maybe they’ll go elsewhere, but either way – they will not be taking a 15 minute appointment and turning it into a 45 minute chit chat, moan, more chit chat, script recommendation, exit strategy.

You say, that making the sessions 20 minutes long would mean the doctor would see less patients, but heck – I’m still a patient, I waited 75 minutes and I was still in there for 5 minutes and the quality of my consultation was not thorough – I was still asking questions when the doctor was getting up to open the door. The system does not work, so fix it – if it means the doctor can only see 20 patients a day instead of 30 but that those patients are well consultated and not inconvenienced whilst sick and miserable then they’re likely to have happier patients who will keep coming back.

Anyone who says their happy to wait 75 minutes, is clearly more tolerant than I (more power to you, relly), or just has nothing better to do (which is what I suspect).

OpenYourMind OpenYourMind 4:55 pm 16 Sep 10

Fisher Family Practice is good. Only trouble is that there’s not a hope in hell of getting in as a new patient. My wife couldn’t get in and they were quite abrupt about it.

The problem with all these people that suggest that your health is more important than your job or running late, miss that if you have children who get sick often or have an ongoing problem then those really big waits can become a real problem and can affect your employment.

If as, JumpingTurkey suggests, our health is so pivotal on good GPs and if there is such a shortage that people can’t even get in to see a GP, then we have something seriously wrong with the system. We need to start looking at the whole GP thing. Can we reduce the training load and have levels of GPs? Can we import more foreign doctors? Can we apply some new technological solutions? Breakdown of an essential service calls for a radical rethink of how that service is provided.

I get a bit annoyed about the harping on of training required to be a Doctor. Lots of jobs require a hell of a lot of training, some jobs also involve lives at risk and are paid a lot less than a GP let alone a specialist. A Doctor can also practice for a very long time. Those same tradies discussed earlier are most unlikely to have long careers as heavier work takes a toll, they still have to do training and low paying apprenticeships.

Woody Mann-Caruso Woody Mann-Caruso 4:21 pm 16 Sep 10

But with many (not all) GPs, it has become the norm, rather than the exception.

Like I said – post a solution. Given a span of hours, provide times for two lengths of appointment, then show how you predict / adapt to these appointments running for a unpredictable length of time to keep all subsequent appointments on time. At any given time, set out how you will determine the time that will pass between now and an appointment slot x places in the future so that you can inform the holder of that slot in a manner that won’t make them wait more than 15 minutes.

Pandanus77 Pandanus77 3:34 pm 16 Sep 10

Fisher Family Practice, its modern, patient focused and at last count 10-12 wonderful doctors.

schmeah schmeah 3:31 pm 16 Sep 10

Lienna – I’m not a random person on a forum, I’m a patient who values their health, time, work as well as the courteous behaviour of others.

If a doctor wants to jerk people around with their time, and fail to advise of excessive delays by using a simple SMS system or phoning the patient (which other rioters have said their doctor’s surgery does use)then, in short, a doctor can expect to have a rioter who is also a patient get angry about it.

If I had have been so rude as to not turn up to my appointment at all, no doubt they would have worked out how to use that phone, put off all that stakeholder liasing they apparently do, and phoned me asking for my $75 standard fee – but apparently, I can’t expect as much as an apology if I turn up on time and am still waiting close to 90 minutes.

Who was talking about my double standards before – oh yeah, a doctor rioter.

schmeah schmeah 2:37 pm 16 Sep 10

Lienna – you miss the point, I’m not dismissive of a doctor who cares for their patients – I am however dismissive of their holier than thou attitude, that means it’s ok to make people wait more than a reasonable windor of time. Next time you make an appointment for anything, a dinner reservation whatever – and you are told to wait an hour and a half – tell us all what you thought of the situation, please.

I don’t have an important job and I don’t think my job is more important than my health, but I do appreciate it when people (doctors included and their staff as well as cafe staff, tradies, office managers) are kind enough to appreciate the personal and professional time of the other half of the meeting party.

Did I get an apology from the doctor when I finally got seen to? No, I didn’t. When I politely raise the fact I had been waiting nearly 90 minutes for my appointment – was the doctor qually courteous? No, instead I belittled and made to feel that it’s to be expected and please get out now, I have 75 minutes to catch up on.

Next time I’m very late for anything, or maybe late to take a coffee or sandwich to a waiting customer I’m going to try the ‘I’m not on holidays, in case you can’t see I work very hard, my sandwiches are above par’ response and see how it goes with the customer.

Genie Genie 2:30 pm 16 Sep 10

I think a doctor should have to provide basic customer service.

My family doctor was ALWAYS late, so late that you knew if you were running 10-15mins late the reception staff would giggle at you when you would call to notify – “don’t worry love he’s about 30mins late” it got to the point where he was such a good doctor you didn’t mind waiting.

These days receptionists get grumpy if you call up to see if they are “on time”. One of the practices I used to go to had signs up – Appointments are only 15mins in duration, should you require longer, please book 2 spots/extended appointment.

I think if doctors were more persistant in forcing patients to obide by a rule like this, wait times wouldn’t be so bad.

And I’m sorry I agree with the OP – if I have an appointment at 4pm. I want to be seen within 10-15mins of my appointment time.

Kizzle Kizzle 2:26 pm 16 Sep 10

@Pandanus77 please share?? 🙂

schmeah schmeah 2:25 pm 16 Sep 10

Pandanus77 – please tell us where your doctor is!

SMS technology and phone calls – previously only reserved for those lowly hairdressers – I thought it would never come to this!

kambahkrawler kambahkrawler 1:50 pm 16 Sep 10

Personally I’ll wait. My health is more important than my job.

bobbatty bobbatty 12:43 pm 16 Sep 10

pptvb said :

WOW!
Didn’t this get nasty?
My mate, a “Tradie”, turned up 10 minutes late to a GP’s house one day….the GP went off her nut!
“How dare he make her wait?”
“Do you know how valuable my time is??”
He just pissed himself laughing.

HA HA yep I know how this feels. I think it’s akin to a God complex..

nhand42 nhand42 12:40 pm 16 Sep 10

JumpingTurkey said :

Hahaha yes sorry if I contributed to this forum turning ‘nasty’. I got a bit heated up last night because here I was as a GP working hard to try to take good care of my patients, and someone accuses me and the entire profession of being reduntant / useless and also driven by nothing but self-interest and desire to make a profit.

Talk about missing the forest for the trees. My rant was about the useless GPs who disrespect their patients by overbooking and missing appointments and then treat their upset patients like dirt, as happened to the OP, and judging by the comments has happened to several other people. Apparently that struck a nerve with you. I wonder why.

Also very amusing to see all the concern trolls rushing in to defend the disrepectful behaviour of obnoxious doctors. Doctors are unjustifiably placed on a high pedestal in Australia. As somebody else so eloquently wrote; doctors are service providers, essential and valuable for sure, but they are not unlike other professionals, and they could learn a thing or two about customer service.

Kudos to the progressive doctors who actually do care about their patients; informing them of delays and keeping their scheduled appointments. Sadly a rare breed.

Pandanus77 Pandanus77 12:07 pm 16 Sep 10

We struck it lucky when we moved to Canberra 8 years ago in that we found a doctors surgery that is modern and progressive in the way it runs its practice (i.e. customer focused). Sure sometimes we need to wait a little while (15-20 minutes) but rarely. The bonus is that they use SMS to remind you of appointments and have at time phones us to let us know that they are running behind schedule.

I guess that their progressive customer focus could be why they keep attracting new doctors to their practice and have been actively growing it for some years. Doctors like many other professionals (lawyers,dentists, etc) are just service providers, sure the service they provide is an essential service, for which they study a considerable amount of time for, but they could learn about customer service from other areas of the service industry. I reckon that my doctors practice has done this and that is the reason for its success.

Pommy bastard Pommy bastard 11:39 am 16 Sep 10

I’ve never had any thing other than a courteous, prompt and understanding service from a GP in Australia.

Some here are prepared (mainly for others) to take a rushed consultation, a potentially life threatening rushed consultation, so that they are not inconvenienced.

When I see a GP, as rare as that event may be, it is for bloody good reason. Do I care if others are slightly inconvenienced, by my doctor checking out what is wrong with me to the best of their ability, in an appropriate amount of time?

Do I bollocks.

Welcome to the real world, sorry we could not rearrange the whole medical system all to suit your convenience.

Some people suffer from NBPE, and nead treatment.

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